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questions.........attempt pls. - peace2011
#1
1 .A 59-year-old sport fisherman from Arizona visits his doctor’s office with a concern regarding a very dry rash on the dorsal aspect of his hand. He first noticed it as a flaky patch of skin 5 years ago, but recently it has grown into a red, raised lesion. The excisional biopsy shows multiple highly eosinophilic foci with concentrically arranged eosinophilic material visible at low magnification. At higher-power magnification, cells with prominent nucleoli are seen in the epidermis and dermis.
Which of the following is a risk factor for the development of this lesion?
A.axanthosis nigricans
B.HPV 11
C.aflatoxin exposure
D.Dysplastic nevi
E.immunosuppression

2. An 18-year-old man presents complaining of an inability to keep his balance. A complete neurologic examination is conducted, and funduscopy reveals retinal hemangioblastomas. He reports that his mother has a history of a “brain tumor,” the specifics of which he is unaware.
Given the classic evolution of this patient’s disease, for which of the following does this patient require close monitoring?
A.depression
B.astrocytoma
C.pheochromocytoma
D.colon cancer
E.renal mass

3. A biotechnology company is developing a small protein to block the cascade by which allergens can cause shock. Patients often die from vasodilation and massive edema; therefore, the new protein could lead to a life-saving drug.
Which of the following molecules is the most promising target to block the anaphylactic pathway?
A.IFN-gamma
B.IgE
C.C5a
D.Hageman factor
E.IL-1
F.NO

4.A 25-year-old woman is brought to the hospital by her parents because she told them she constantly hears voices that insult her and tell her to perform various actions. After a brief stay on the psychiatric floor she was discharged with a prescription for haloperidol.
Which of the following is an adverse effect of this medication?
A.ataxia
B.diarrhea
C.galactorrhea
D.hypertension
E.depression

5.A 25-year-old man underwent arthroscopic knee surgery to repair a torn lateral meniscus in his right knee. The patient consented to general anesthesia for the operation. During the surgery the patient suddenly develops sporadic repetitive muscle jerking in the neck and extremities. There is no associated rigidity or fever.
Which of the following inhaled anesthetics was most likely used?
A.enflurane
B.isoflurane
C.halothane
D.nitric oxide
E.thiopental

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#2
1 B
2 B
3 E
4 C
5 C
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#3
hmm
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#4
?? Answers please!
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#5
1. d
2. e (this pt has Von Hippel-Lindau Disease)
3. c C5a is an anaphylatoxin, causing the release of histamine from mast cells
4. c
5. a ( its a proconvulsant)
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#6
1.D
2.E
3.C
4.C
5.A
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#7
Dysplastic nevi,
Renal Mass,
Haloperidol-galactorhea
Halothane
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#8
nice attempt guys.i'll post the answers with the explanations and refrence to your FA.these are some of the questions from usmlerx.
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#9
3. C
4. E
5. A
i am not sure for first two.
2. C ??
1. E??
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#10
1 .A 59-year-old sport fisherman from Arizona visits his doctor’s office with a concern regarding a very dry rash on the dorsal aspect of his hand. He first noticed it as a flaky patch of skin 5 years ago, but recently it has grown into a red, raised lesion. The excisional biopsy shows multiple highly eosinophilic foci with concentrically arranged eosinophilic material visible at low magnification. At higher-power magnification, cells with prominent nucleoli are seen in the epidermis and dermis.
Which of the following is a risk factor for the development of this lesion?
A.axanthosis nigricans
B.HPV 11
C.aflatoxin exposure
D.Dysplastic nevi
E.immunosuppression

EXPLANATION:answer is E
A rash on the hand(a classic location for squamous cell carcinoma)that eventually grows into a red lesion suggests an actinic keratosis that has transformed into a squamous cell carcinoma.The histologic description of the low-power view is typical of "keratin pearls".The high-power view demonstrates malignant cells infiltrating the dermis.Immunosuppression is a risk factor for squamous cell carcinoma,as seen in recipients of solid organ transplants,individuals with chronic immunosuppression of inflammatory disorders,and HIV disease.
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